Mental Health in China

How does mental health in China compare to mental health for Chinese Americans? A recently disturbing article highlights how stigma can prevent individuals from getting proper care for mental disorders. In the link below, one will see how manageable mental illnesses can impact society if left untreated.

http://www.nytimes.com/2010/11/11/world/asia/11psych.html?_r=1&emc=eta1

What are your thoughts about consequences of untreated mental illnesses? Barriers to treatment due to lack of knowledge, lack of resources, or stigma can end up negatively affecting our communities.

Stress in Los Angeles

We've heard about the American Psychological Association's Stress in America survey. Do you know the stress levels for your local area? Find out what stresses Angelenos out:

http://abclocal.go.com/kabc/story?section=news/local/los_angeles&id=7775744

Check out the video and see what you can do to help alleviate stress. What do you do to destress?

Stress in America

Stress in America affects our health (e.g., disturbed eating, sleeping, and relationships).

http://www.scpr.org/programs/airtalk/2010/11/09/stress-2010-americans-on-edge/

Ways that stress could manifest among Asian Americans tend to be more psychosomatic than in the general population. Additionally, Asian Americans may be reluctant to disclose their personal issues to people outside the family. Therefore, it's important to keep in mind to engage in healthy self care (e.g., exercise, healthy eating, adequate sleep, etc.) rather than employing unhealthy coping mechanisms (e.g., smoking, drinking, gambling).

How do you know you are stressed out and how do you deal with stress?

The Gangster We Are All Looking For

Le Thi Diem Thuy wrote a New York Times Notable Book as her debut novel. "The Gangster We Are All Looking For" is an easy read with a lyrical style that moves between space and time to depict the true story of her refugee family.

Le's family's tragic history is not unlike other Vietnamese and South East Asian refugee backgrounds. Fleeing one's beloved homeland involuntarily to dangers during the journey to safer lands is not uncommon among South East Asian families, such as those from Vietnam, Cambodia, and Laos. Unspeakable atrocities tear families apart and ravage the well being of otherwise happy lives.

There is a distinction between immigrants (who migrate willingly, and usually with adequate preparation or resources) and refugees (typically those who flee their countries of origins abruptly due to safety). Mental health professionals need to assess which background contributed to their clients' migration to their host countries. This will have implications for issues, such as: PTSD (post-traumatic stress disorder).

What books have you read lately? I'd welcome your thoughts on this moving story or others...

Handbook of Asian American Psychology

In 1998, Zane and Lee published the Handbook of Asian American Psychology. It contained groundbreaking chapters from experts in the field of Asian American mental health. http://www.uk.sagepub.com/refbooksProdDesc.nav?prodId=Book3931

Nearly a decade later, several co-editors collaborated on the long-awaited second edition: http://www.sagepub.com/booksProdDesc.nav?contribId=533177&prodId=Book228036. This second edition contains information regarding special populations (e.g., older adults and international students) as well as adjustment issues (e.g., racism, family violence, and psychopathology).

Do you have any favorite books that you reference on this matter?

Speak up!

Asian Americans are seen as passive in the classroom and work environments. Why is that? From a Western standpoint, this could be viewed negatively. Imagine this: a teacher is conducting a classroom discussion and grades class participation as 20% of the class. The teacher notices that the Asian American student never volunteers during class discussions and only responds when called upon. Therefore, the teacher decides that the student is not assertive in the classroom setting and grades accordingly. A similar scenario can be seen in a mainstream work environment, which may help to explain the glass ceiling in regards to Asian American employees. This could be detrimental to one's academic and/or work performance.

From an Eastern standpoint, however, this could be culturally congruent. In the situations where the nail that stands up gets hammered down, one is expected not to stand out above others. Similarly, there is a hierarchy in Asian societies that dictate those of lower social status (e.g., student/employee) should defer to those of higher status (e.g., teacher/supervisor). Additionally, there is also the concept of avoiding losing face at all costs. In the Eastern efforts to maintain face and harmony, speaking out may not be in the best interest of the group.

What to do? Asian Americans can challenge themselves to be more assertive when the situation deems appropriate. At the same time, educators and employers may want to be more culturally sensitive and offer permission to their students/subordinates to encourage verbal participation and assertiveness.

Confucius says...

Ever wonder how some Asian cultures have clear roles for how people should behave in society? Confucianism permeates throughout many of the East Asian cultures and influences other parts of Asia as well. Confucius was a scholar/philosopher in China who believed in social order. For example, children should respect their elders and citizens should respect authority figures. This has implications for filial piety (see more on this idea in a future posting) and being a law-abiding citizen.

Confucianism also has an impact on how gender roles are played out in (East) Asian societies. Ever heard of the law of three obediences? As a girl, females are expected to follow their fathers. As an adult, females are expected to follow their husbands. In their later years, females are expected to follow their sons. This means that a patriarchal society will value male opinions more in order to maintain social hierarchies.

No matter whether or not you agree with Confucianism, one can not argue the vast influence this school of thought continues to have on Asian (American) societies. I welcome your thoughts on this matter.

Communication Across Immigrant Generations

In April of 2010, several Taiwanese (American) Women gathered in Toronto, Canada to discuss the complexities of intergenerational communication. Click on the link below to see one woman's take on the Roundtable Discussion.

http://natwaii.blogspot.com/2010/06/roundtable-discussion-with-dr-michi-fu.html

Collectivism vs. Individualism

Asian societies tend to be "collectivistic" in nature, as are many other ethnically diverse communities. This means that the members of a group would behave in ways that are more conducive to the community, rather than thinking about the individual first. This is in contrast to Western societies, where "individualism" is valued. An example would be Americans are taught to be number one and competition is often between individuals. In societies that are collectivistic, individuals may sacrifice their personal needs on behalf of the greater good. An example would be all members of a household working at a family owned business on top of their own responsibilities.

What might be a reason for the collectivism? Asian famly structures often translate into intergenerational households. In addition to the nuclear family of parents and children, grandparents may also reside in the same home. At times, unmarried siblings of the parents may also live with the host family. In other instances, siblings and their respective families may live in close proximity with one another. This would mean that all members need to learn to live in harmony with one another without disrupting others. Therefore, the members of the household learn to interact with family members in a way that does not cause tension for others.

Somaticization

Asian Americans aren't encouraged to say things like: "I feel nervous now." "You make me upset." or "Hearing that saddens me." These are considered too direct methods of conveying negative states of emotions. In fact, there are very limited ranges of negative feelings that can be expressed in many of the Asian languages. However, in Western languages, there are a wide range of ways one can express feeling angry. For example, one can be annoyed or perturbed vs. incensed and outraged.

Instead, Asian Americans have alternative methods of conveying their negative feelings. These are usually expressed physiologically. This means that one could have recurring stomach aches or head aches when they are actually experiencing stress or relationship difficulties. This is why it is not uncommon for primary care physicians to refer Asian Americans for mental health screenings when an organic explanation is not available for a somatic complaint. Therefore, pay attention to your body and what it might be telling you.

PTSD & Asian Americans

There was an earthquake in Southern California this past week. Did anyone feel it? Did it remind you of earthquakes years ago? For some, traumatic events such as earthquakes bring about nightmares, frightening memories, or even physical symptoms. If you are Asian American, chances are you express your post-traumatic stress disorder (aka: PTSD) as somatic symptoms. This means that instead of being able to say to others that a frightening event continues to haunt you, it may be more common for you to have a head ache or stomach ache. Stay tuned to hear more about Asians and somaticization of symptoms.

Within Group Differences

Folks who are not Asian may think that all Asians look and act alike. Turns out that differences transcend food and language preferences. A little known fact is that there are many "within group" differences that may lead to splintering within the Asian American community. The historical impact of wars fought centuries ago many lead to current day inability to collaborate with one another. Some Asians are the most "xenophobic" (fear of others) and this may lead to an unwillingness to learn about other groups.

How to combat this? Communication and a willingness to explore similarities rather than highlighting differences may help to reduce the within group tensions that are experienced within the Asian American community. Be open to learning about other groups beyond a superficial level and one may find that there are more commonalities than previously thought.

Saving Face & Stigma

Asian Americans tend to seek mental health services at a lower rate than the general public. Is this because they tend to have fewer mental health issues? It is actually because Asian Americans have a cultural value called "saving face" that prevents them from airing dirty laundry publicly (e.g., seeking help through a third party). By the time an individual or family seeks mental health treatment, they are usually far more severe than their counterparts. Therefore, it's important to understand the cultural implications for "losing face" by seeking services and encourage Asian Americans to seek help in the earlier phases of potential problem resolution since studies also show that prevention (before a problem arises) and early intervention (just when an issue becomes problematic) tend to be more effective than crisis intervention (when a problem has gotten out of control).

Model Minority Myth

Asian Americans are often touted as the model minorities. This usually means that Asians get good grades, make an above average household income, and are generally good citizens that cause little civil disturbances.

Sounds good? This is actually a harmful stereotype that pits Asian Americans against one another and other minority groups. What happens if an Asian American youth doesn't fall into the category of being good at math, playing a musical instrument, and being college-bound?

Not conforming to the Model Minority Myth could lead to symptoms of anxiety or depression. This also means that those families who might benefit from social services may not be able to readily seek help. Statistics actually show that most Asian Americans do not fit this stereotype, yet the myth is perpetuated.

Acculturation

Different levels of acculturation are often the main contributing factor to immigrant families experiencing conflicts. What does this mean? Simply, that those who bring values from another culture (e.g., Asia) and raise children in the host culture (e.g., United States), may have different ideas of what types of food, music, and romantic relationships are appropriate. How to get around this? Communication is the key. Cherishing differences and talking out our expectations with one another can help to reduce the culture gap. For more information, contact Dr. Michi Fu at drmichifu@gmail.com.